P4355 - Disparities and Trends in Cholecystitis-Related Mortality Among Diabetic Adults in the United States, 1999–2020: A Population-Based Analysis Using CDC WONDER

Usama Sakhawat, MD¹, Usman Mazhar, MBBS², Hafsah Ali, MBBS³, Ali Hamza, MBBS⁴, Fnu Veena, MD⁵, Muhammad Hamza Rafique, MD⁶, Muhammad Khizar Asif, MBBS⁷, Sheena Shamoon, MD⁸, Kinza Bakht, MBBS⁹, Muhammad Arham, ¹⁰, Allah Dad, MD¹¹, Faseeh Haider, MD¹², Faizan Ahmad, MD¹³, Muhammad Usman Shahbaz, MD¹⁴, Rama Hassan, MBBS¹⁵, Ahmed Shehadah, MD¹⁶, Khandokar Talib, MD¹⁷, Toseef Javaid, MD¹
1United Health Services, Wilson Medical Center, Johnson City, NY; 2Rawalpindi Medical University, Pakistan, Rawalpindi, Punjab, Pakistan; 3Allama Iqbal Medical College, Manama, Al Muharraq, Bahrain; 4Army Medical College, Rawalpindi, Punjab, Pakistan; 5BronxCare Health System, Bronx, NY; 6Woodhull Medical Center, Brooklyn, NY; 7University Hospital Coventry and Warwickshire,Coventry,England, Coventry, England, United Kingdom; 8University at Buffalo, Buffalo, NY; 9Sheikh Zayed Medical College Rahim Yar Khan, Muzaffargarh, Punjab, Pakistan; 10Sheikh Zayed Medical College, Pakistan, Rahim Yar Khan, Punjab, Pakistan; 11Shiekh Zayed Medical College Rahim Yar Khan, Pakistan, Kot Addu, Punjab, Pakistan; 12Allama Iqbal Medical college, Lahore, Punjab, Pakistan; 13Duke University, Durham, NC; 14Mercy Hospital Fort Smith, ARCOM, Fort Smith, AR; 15Akhtar Saeed Medical and Dental College, Lahore, Binghamton, NY; 16United Health Services, Wilson Medical Center, Binghamton, NY; 17United Health Services, Johnson City, NY

Introduction: Cholecystitis, a common gallstone disease complication, may pose a higher mortality risk in diabetic patients due to immunometabolic dysfunction and delayed diagnosis. However, national trends and demographic disparities in cholecystitis-related mortality among diabetic adults remain poorly characterized.

Methods: We analyzed CDC WONDER multiple cause-of-death data (1999–2020), identifying deaths listing both diabetes mellitus (ICD-10 E10–E14) and cholecystitis (K81). Age-adjusted mortality rates (AAMRs) per 1,000,000 population were calculated for U.S. adults aged ≥25 years and assessed using Joinpoint regression, stratified by sex, race/ethnicity, age groups, Census region, state, and 2013 urbanization level.

Results: From 1999 to 2020, AAMR for cholecystitis among diabetic adults showed a non-significant rise from 1999–2002 (APC: +8.6%), a significant decline from 2002–2015 (APC: –2.1%), followed by a significant rise from after 2015 (APC: +5.9%). Overall AAPC was +1.26% ( p=0.13). A total of 8,470 deaths were recorded.Racially, AAMR was highest in American Indian or Alaska Native (3.3), followed by Hispanic or Latino (2.9), Black or African American (2.7), Asian or Pacific Islander (1.8), and White (1.5). AAMRs increased for both genders; males had consistently higher rates, rising from 2.0 to 2.8, compared to 1.4 to 1.8 in females. Regionally, the highest rate was in the West (2.1), followed by the Midwest and South (1.7 each), and the Northeast (1.6). AAMRs increased in both metropolitan (1.7 to 2.2) and non-metropolitan areas (1.7 to 2.5), with a greater rise in the latter. Among middle-aged adults (45–64), AAMR increased from 0.7 to 1.2, with a significant post-2015 rise (APC: +9.24%, CI: 1.59-17.46). In older adults (≥65), AAMRs rose from 7.0 in 1999 to 8.1 in 2020, with an initial increase from 1999 to 2002 (APC: +8.79%, CI: –3.08 to 22.12), a significant decline from 2002 to 2015 (APC: –1.99%, CI: –3.14 to –0.83), and a significant rise from 2015 to 2020 (APC: +4.56%, CI: 0.69 to 8.58, p < 0.05).

Discussion: Rising cholecystitis-related mortality among diabetic adults, particularly among Hispanics, males, residents of the West and non-metropolitan areas, along with a post-2015 increase in mortality among middle-aged and older adults, underscores the importance of implementation of stratified public health policies and clinical protocols tailored to demographic and regional risk factors to reduce mortality and improve outcomes.


Figure: Figure 1: Disparities and Trends in Cholecystitis-Related Mortality Among Diabetic Adults in the United States, 1999–2020.

Disclosures:
Usama Sakhawat indicated no relevant financial relationships.
Usman Mazhar indicated no relevant financial relationships.
Hafsah Ali indicated no relevant financial relationships.
Ali Hamza indicated no relevant financial relationships.
Fnu Veena indicated no relevant financial relationships.
Muhammad Hamza Rafique indicated no relevant financial relationships.
Muhammad Khizar Asif indicated no relevant financial relationships.
Sheena Shamoon indicated no relevant financial relationships.
Kinza Bakht indicated no relevant financial relationships.
Muhammad Arham indicated no relevant financial relationships.
Allah Dad indicated no relevant financial relationships.
Faseeh Haider indicated no relevant financial relationships.
Faizan Ahmad indicated no relevant financial relationships.
Muhammad Usman Shahbaz indicated no relevant financial relationships.
Rama Hassan indicated no relevant financial relationships.
Ahmed Shehadah indicated no relevant financial relationships.
Khandokar Talib indicated no relevant financial relationships.
Toseef Javaid indicated no relevant financial relationships.

Usama Sakhawat, MD¹, Usman Mazhar, MBBS², Hafsah Ali, MBBS³, Ali Hamza, MBBS⁴, Fnu Veena, MD⁵, Muhammad Hamza Rafique, MD⁶, Muhammad Khizar Asif, MBBS⁷, Sheena Shamoon, MD⁸, Kinza Bakht, MBBS⁹, Muhammad Arham, ¹⁰, Allah Dad, MD¹¹, Faseeh Haider, MD¹², Faizan Ahmad, MD¹³, Muhammad Usman Shahbaz, MD¹⁴, Rama Hassan, MBBS¹⁵, Ahmed Shehadah, MD¹⁶, Khandokar Talib, MD¹⁷, Toseef Javaid, MD¹. P4355 - Disparities and Trends in Cholecystitis-Related Mortality Among Diabetic Adults in the United States, 1999–2020: A Population-Based Analysis Using CDC WONDER, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.